Comparison of Value of Leads from Body Surface Maps to 12-Lead Electrocardiogram for Diagnosis of Acute Myocardial Infarction

Owens, Colum; McClelland, Anthony; Walsh, Simon; Smith, Bernie; Adgey, Jennifer

doi:10.1016/j.amjcard.2008.03.046

Cited by 33 publications

(28 citation statements)

References 14 publications

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“…Perron et al [21] found that the addition of seven inverted leads to the standard 12 positive leads maximally increases the sensitivity of ECG for the detection of acute transmural ischaemia with a minimal loss of specificity. It has also been reported that a technique known as body surface potential mapping improves the detection of occlusions of the culprit arteries in patients without ST-segment elevation on initial 12-lead ECGs [22,23]. Body surface potential mapping could increase STEMI detection by 27.5% over that obtained with standard ECG [24].…”

Section: Discussionmentioning

confidence: 99%

Total coronary occlusion of infarct-related arteries in patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary revascularisation

et al. 2017

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A b s t r a c t Background:The prevalence and impact of total coronary occlusion of an infarct-related artery (IRA) on outcomes in patients with non-ST-elevation myocardial infarction (NSTEMI) remain unclear. Aim:We evaluated the clinical significance of total coronary occlusion in NSTEMI patients. Methods:A total of 2767 patients with NSTEMI enrolled in the Polish Registry of Acute Coronary Syndromes, who underwent percutaneous coronary interventions, were analysed. The patients were divided into two groups according to preprocedural culprit vessel thrombolysis in myocardial infarction (TIMI) flows (TIMI flow 0 -total coronary occlusion [TO]: 728, 26.3% of the patients, and TIMI flow 1-3 -non-total occlusion [non-TO]: 2039, 73.7% of the patients).Results: Patients with total occlusion were younger, were more often current smokers, and had lower incidence of hypertension and diabetes mellitus. The left circumflex artery (LCx) was the major IRA in the TO group (48.1%), whereas the left anterior descending artery (LAD) was more commonly the IRA in the non-TO group (38.8%). Multivariate analysis revealed that LCx as the culprit lesion (OR ± 95 CI 1.54 [1.26-1.89], p < 0.0001) was an independent predictor of TIMI flow 0 in IRA. In-hospital and one-month mortality occurred more frequently in the TO group (4.0% vs. 1.7%, p = 0.0005 and 5.5% vs. 3.5%, p = 0.0175, respectively), no differences in the 12-, 24-, or 36-month mortalities were observed between these groups. Conclusions:Only LCx as a culprit lesion was an independent predictor of total occlusion in IRAs. The NSTEMI patients with TO had higher in-hospital and one-month mortalities, but their long-term outcomes were similar to those of non-TO patients.

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Section: Discussionmentioning

confidence: 99%

Total coronary occlusion of infarct-related arteries in patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary revascularisation

et al. 2017

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“…The BSM identifies acute myocardial infarction in chest pain patients more effectively than the 12-lead ECG by detecting ST elevation in areas outside the traditional sampling region of the 12-lead ECG [8]. From this population ( Fig.…”

Section: Patient Selectionmentioning

confidence: 99%

“…1), patients were recruited on the basis of the selection criteria outlined in Table 1 aiming to identify patients likely to have inferolateral perfusion defects. The initial ECG criteria were ST depression C0.1 mV in C1 of leads I, aVL, V1-V6 (with or without ST elevation) or on the BSM ST elevation (STE) C0.05 mV in C1 of posterior leads (leads 62-77) [8]. All patients had a cTroponin T taken 12 h after the onset of the chest pain.…”

Section: Patient Selectionmentioning

confidence: 99%

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Myocardial wall motion and thickening assessment in early gated SPECT images of acute coronary syndrome patients likely to have inferolateral perfusion defects

Neill

Harbinson

Adgey

2010

Int J Cardiovasc Imaging

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The purpose of this study was to compare semi-quantitative visual scores of perfusion, motion and thickening with an automated hypoperfusion index (HI) in patients with suspected acute inferolateral perfusion defects. In the absence of perfusion defects motion and thickening abnormalities were assessed. Sixty-eight patients with chest pain at rest and either ST depression ≥0.1 mV in ≥1 of leads I, aVL, V1-V6 on 12-lead ECG or ST elevation ≥0.05 mV in ≥1 posterior lead on the body surface map comprised the study population. A rest gated perfusion scan was performed within 24 h of symptoms. Scans were scored for perfusion, motion and thickening semi-quantitatively. The scores were compared to the automated HI. A 12 h Troponin T >0.09 ng/ml indicated myocardial infarction (MI). Sixty-five patients (96%, 65/68) had MI. The summed perfusion score correlated well with the HI (ρ = 0.90, P < 0.01) and agreement between scorers was good (κ = 0.77, 95% CI = 0.57-0.94). The summed motion score correlated with the HI (ρ = -0.61, P < 0.01) and agreement between scorers was moderate (κ = 0.65, 95% CI = 0.52-0.79). Summed thickening score correlated with HI (ρ = -0.67, P < 0.01) and agreement between scorers was good (κ = 0.74, 95% CI = 0.64-0.88). Of the 1156 segments assessed (68 × 17), 542 had normal perfusion. Of these normally perfused segments, 113 (21%, 113/542) had a motion abnormality and 102 (19%, 102/542) had a thickening abnormality. Three patients with proven myocardial infarction had normal myocardial perfusion (HI ≤ 5) but exhibited wall motion and thickening abnormalities. In conclusion, assessment of wall motion and thickening in addition to perfusion in acute myocardial perfusion imaging may improve the diagnostic sensitivity for acute MI. Of the scores addressing motion and thickening, interobserver agreement was better for the summed thickening score.

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“…That is why BSPM is an applicable method to diagnose not only the acute coronary syndromes [4][5][6][7] but minor changes of the repolarization [8,9] or the old non-Q wave myocardial infarction, too [10][11][12]. BSPM is able to detect the minor electrical potentials (EP) of the atria as well as to evaluate their small potential changes [13][14][15][16][17][18][19][20], therefore nowadays it is a useful tool in the investigation of the atrial rhythm disturbances [21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of the left atrial electrical potentials detected by body surface potential mapping in the prediction of coronary artery disease

Bauernfeind

Préda

Szakolczai

et al. 2011

International Journal of Cardiology

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Comparison of Value of Leads from Body Surface Maps to 12-Lead Electrocardiogram for Diagnosis of Acute Myocardial Infarction

Cited by 33 publications

References 14 publications

Total coronary occlusion of infarct-related arteries in patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary revascularisation

Total coronary occlusion of infarct-related arteries in patients with non-ST-elevation myocardial infarction undergoing percutaneous coronary revascularisation

Myocardial wall motion and thickening assessment in early gated SPECT images of acute coronary syndrome patients likely to have inferolateral perfusion defects

Diagnostic value of the left atrial electrical potentials detected by body surface potential mapping in the prediction of coronary artery disease

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